The practice of traditional Aboriginal medicine within Australia is at risk of being
lost due to the impact of colonisation. Displacement of people from traditional lands
as well as changes in family structures affecting passing on of cultural knowledge
are two major examples of this impact. Prior to colonisation traditional forms of
healing, such as the use of traditional healers, healing songs and bush medicines
were the only source of primary health care. It is unclear to what extent traditional
medical practice remains in Australia in 2013 within the primary health care setting,
and how this practice sits alongside the current biomedical health care model. An
extensive literature search was performed from a wide range of literature sources
in attempt to identify and examine both qualitatively and quantitatively traditional
medicine practices within Aboriginal Australia today. Whilst there is a lack of academic
literature and research on this subject the literature found suggests that traditional
medicine practice in Aboriginal Australia still remains and the extent to which it
is practiced varies widely amongst communities across Australia. This variation was
found to depend on association with culture and beliefs about disease causation, type
of illness presenting, success of biomedical treatment, and accessibility to traditional
healers and bush medicines. Traditional medicine practices were found to be used sequentially,
compartmentally and concurrently with biomedical healthcare. Understanding more clearly
the role of traditional medicine practice, as well as looking to improve and support
integrative and governance models for traditional medicine practice, could have a
positive impact on primary health care outcomes for Aboriginal Australia.
Traditional medicine practice (TMP) within Aboriginal Australia encompasses a holistic
worldview which reflects that of the World Health Organizations definition of health,
which is one of ‘physical, mental and social wellbeing and not merely the absence
of disease or infirmity’ [1]. This worldview recognises good health as a complex system involving interconnectedness
with the land, recognition of spirit and ancestry, and social, mental, physical and
emotional wellbeing both of the individual and the community [2]. Indigenous Australians view ill health as the result of one of three causes – a
natural physical cause, a spirit causing harm, or sickness due to sorcery [3]. The impact of colonisation and the subsequent displacement and disconnection of
people both from their traditional lands and later from their traditional families
has been significant in its subsequent effect in the use of traditional practices
including traditional medicine [4].
The Alma-Ata declaration on primary health care (PHC) by the World Health Organization
(WHO) in 1978 witnessed a response from several countries to improve their traditional
medicine use and regulation of use within the primary health care model. PHC for Aboriginal
and Torres Strait Islander Australians is currently addressed by either government
controlled health services or community controlled health services (ACCHS) that offer
biomedical health care and employment to trained Aboriginal Health Workers (AHWs).
ACCHS are initiated and governed by the local Aboriginal Community to enable delivery
of holistic and culturally appropriate healthcare to the respective community/ies
[5]. This holistic approach in the evolvement from primary medical care to primary health
care as adopted by the Alma-Ata declaration in 1978 has been praised, however there
has been no mention of the incorporation of traditional medicine use within the design
of these health services as other countries have [6]. It is acknowledged that in remote areas in other countries it is common for traditional
medicine to coexist with biomedical healthcare as part of a pluralistic medical system
[7]. It is unclear if this also applies to Aboriginal Australia and if so, to what extent
traditional medicine is practiced and how it sits with the use of biomedical healthcare.
The purpose of this review is to identify available literature that examines or discusses
the role (as in position/function) of TMP in a PHC setting within Aboriginal Australia.
Treatment modalities within TMP for the review will be inclusive of Traditional Healers
(TH), herbal medicines, ceremonies and healing songs [8]. Whilst it is recognised that bush foods also play a role in traditional health practices,
specific articles on bush tucker and nutrition will not be included due to the limitations
on the length of this review. TMP will be examined overall for the extent/level of
use, when they are used (i.e. first or second line), how they are used (i.e. alone or in combination with biomedicine), what they are used for (i.e. types of illnesses) and the reasons behind the when, how
and what.
http://www.ethnobiomed.com/content/9/1/46
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